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															      <td height="36" class="empleadohms">Cajero</td>
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															      <td height="36" class="enlaceshms"><u>Registrar Pago</u></td>
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								<strong class="b_text">Registro de Pago a Caja</strong><br />
								<p class="p1">. </p>
								<div class="pd">
								  <form id="form1" method="post" action="">
								    <table width="200" border="0">
								      <tr>
								        <td>ID Pago:</td>
								        <td><label for="pago"></label>
							            <input type="text" name="pago" id="pago" /></td>
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								  <p>&nbsp;</p>
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							  <p align="center"><strong>Datos del Paciente</strong></p>
							  <form id="form2" method="post" action="">
							    <table width="439" border="0">
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							        <td>&nbsp;</td>
							        <td height="17" colspan="4">&nbsp;</td>
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							      <tr>
							        <td width="114">ID Paciente:</td>
							        <td height="30" colspan="4"><p>
							          <label for="IDpaciente"></label>
							          <input type="text" name="idPaciente" id="IDpaciente" />
							          <input type="submit" name="button" id="button" value="Buscar" />
							        </p>
                                    </td>
						          </tr>
							      <tr>
							        <td>Nombre:</td>
							        <td height="26" colspan="4"><input name="nombre" type="text" id="nombre" size="40" /></td>
						          </tr>
							      <tr>
							        <td>Apellido:</td>
							        <td height="26" colspan="4"><label for="PacApe"></label>
						            <input name="PacApe" type="text" id="PacApe" size="40" />							          <label for="nombre"></label></td>
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							        <td>&nbsp;</td>
							        <td height="24" colspan="4"><label for="DNI"></label></td>
						          </tr>
							      <tr>
							        <td>Tipo de Servicio:</td>
							        <td height="25" colspan="4"><label for="nacionalidad"></label>
							          <select name="PacNac" id="nacionalidad">
							            <option value="1">Consulta</option>
                                      </select></td>
						          </tr>
							      <tr>
							        <td>Monto:</td>
							        <td height="23" colspan="4"><label for="monto"></label>
						            <input type="text" name="monto" id="monto" /></td>
						          </tr>
							      <tr>
							        <td>&nbsp;</td>
							        <td height="28" colspan="4"><label for="dia"></label>							          <label for="mes"></label>							          <label for="anho"></label></td>
						          </tr>
							      <tr>
							        <td>&nbsp;</td>
							        <td height="36" colspan="4"><label for="departamento"><strong>Pago con Tarjeta </strong></label></td>
						          </tr>
							      <tr>
							        <td>Tarjeta de Crédito:</td>
							        <td width="64" height="31"><label for="tarjetaCredito"></label>
							          <select name="PacTarCre" id="tarjetaCredito">
							            <option>VISA</option>
				                    </select></td>
							        <td height="31" colspan="2"><label for="NumTarjeta"></label></td>
							        <td width="79">&nbsp;</td>
						          </tr>
							      <tr>
							        <td height="34">Número de Tarjeta:</td>
							        <td colspan="4"><input name="PacNumTar" type="text" id="numTarjeta" size="16" maxlength="16" /></td>
						          </tr>
							      <tr>
							        <td height="17">&nbsp;</td>
							        <td colspan="4">&nbsp;</td>
						          </tr>
							      <tr>
							        <td height="35">:</td>
							        <td>&nbsp;</td>
							        <td width="63"><input name="Aceptar" type="submit" class="botonHms" id="Aceptar" value="Registrar" /></td>
							        <td width="12">&nbsp;</td>
							        <td><input name="Cancelar" type="submit" class="botonHms" id="Cancelar" value="Cancelar" /></td>
						          </tr>
						        </table>
							    <p>&nbsp;</p>
                                <p></p>
					        </form>
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